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目的探讨数字化乳腺X线检查与MR扩散加权成像(DWI)对乳腺良恶性病变的诊断价值。资料与方法搜集经手术病理证实或穿刺活检证实的50例乳腺癌患者和59例乳腺良性病变患者。应用数字化乳腺机行乳腺内外侧斜位、头尾位摄片。采用GE 1.5T超导磁共振扫描仪,乳腺专用线圈,DWIb值分别为400 s/mm2、600 s/mm2、800 s/mm2、1000 s/mm2,测量病灶区域的表观扩散系数(ADC)值,并用SPSS 11.5软件进行统计学分析。结果钼钯X线发现钙化灶36例,其中乳腺癌16例。4组b值乳腺癌及良性病变,恶性组ADC值明显低于良性组,差异有统计学意义(P<0.05)。并分别绘制受试者工作特征(ROC)曲线,以b=1000 s/mm2时,曲线下面积(AUC)最大,诊断价值最高。以ADC值为1.23×10-3 mm2/s作为诊断阈值与钼靶进行比较,乳腺钼钯X线发现乳腺癌的敏感性、特异性、阳性预测值、阴性预测值分别为56.8%、67.7%、54.3%、69.8%;DWI分别为90.0%、59.4%、56.3%、91.1%。结论 DWI检测乳腺癌的敏感性较高,特异性较低,但乳腺X线摄影可以很好地显示钙化灶,两者结合可以明显提高乳腺癌的诊断准确性。
Objective To investigate the value of digital mammography and MR diffusion weighted imaging (DWI) in the diagnosis of benign and malignant breast lesions. Materials and Methods Collected 50 cases of breast cancer and 59 cases of benign breast disease confirmed by pathology or biopsy. Application of digital breast machine inside and outside the breast oblique, head and tail bit of the film. The apparent diffusion coefficient (ADC) of the lesion area was measured with a GE 1.5T superconducting magnetic resonance scanner and a dedicated breast loop with DWIb values of 400 s / mm2,600 s / mm2,800 s / mm2,1000 s / mm2, respectively. Values, and SPSS 11.5 software for statistical analysis. Results Molybdenum Palladium X ray found 36 cases of calcification, including 16 cases of breast cancer. The ADC value of 4 groups of b-value breast cancer, benign lesion and malignant group was significantly lower than that of benign group, the difference was statistically significant (P <0.05). The ROC curves were plotted separately. The maximum area under the curve (AUC) was obtained at b = 1000 s / mm2, with the highest diagnostic value. The sensitivity, specificity, positive predictive value and negative predictive value of breast cancer were 56.8%, 67.7% respectively when the ADC value was 1.23 × 10-3 mm2 / s as the diagnostic threshold. , 54.3% and 69.8% respectively; DWI was 90.0%, 59.4%, 56.3% and 91.1% respectively. Conclusion The sensitivity and specificity of DWI in the detection of breast cancer are high and low, but mammography can show the calcification well. The combination of the two can obviously improve the diagnostic accuracy of breast cancer.